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NPI Code Detail

MEDICARE: KIMOANH THI NGUYEN

MEDICARE: KIMOANH THI NGUYEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95018074CA

General Provider Information

NPI Number : 1801556188
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMOANH THI NGUYEN
Provider Business Mailing Address
First Line : 8052 CAMBRIA CIR
Second Line :
City : STANTON
State : CA
Zip : 90680-8503
Country : US
Telephone Number : 714-270-5284
Fax Number :
Provider Business Practice Location Address
First Line : 12865 MAIN ST STE 105
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 800-768-1977
Fax Number : 800-768-1977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2021
Last Update Date : 12/28/2021

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Directions to “ KIMOANH THI NGUYEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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